tag:blogger.com,1999:blog-3285901542589086582018-03-05T13:40:36.223-07:00Dr. JBoise, Idaho
Endurance Sports MedicineJeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.comBlogger63125tag:blogger.com,1999:blog-328590154258908658.post-68733015464224733082014-03-05T13:21:00.001-07:002014-03-05T13:21:04.285-07:00Balance and the Boys<div class="MsoNormal"><span style="font-family: Times, Times New Roman, serif;">Just finished reading a <a href="http://epiccamp.blogspot.co.nz/">blog that Scott Molina</a> wrote regarding the recent completion of the 30<sup>th</sup> anniversary edition of Ironman New Zealand.<span style="mso-spacerun: yes;">&nbsp; </span>I’ve thoroughly enjoyed the little time that I’ve spent with Scott.<span style="mso-spacerun: yes;">&nbsp; </span>He is incredibly engaging and direct…the kind of guy that pushes your buttons because of his no nonsense approach to training and life.<o:p></o:p></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="font-family: Times, Times New Roman, serif;"><span style="mso-spacerun: yes;">&nbsp;</span>But honestly, I’m left with conflicting thoughts and feelings.<span style="mso-spacerun: yes;">&nbsp; </span>On one hand, I love that he shares the pain and suffering experienced to continue to race, train, and compete.<span style="mso-spacerun: yes;">&nbsp; </span>I’ve always been in awe of those folks that I’ve had the privilege to train with that seem to be able to bury themselves to depths that I can only imagine.<span style="mso-spacerun: yes;">&nbsp; </span><a href="http://www.scottmolina.com/">Scott</a>, <a href="http://en.wikipedia.org/wiki/Samantha_McGlone">Sam McGlone</a>, and <a href="http://coachgordo.wordpress.com/">Gordo</a> are a few retired pros that come to mind.<span style="mso-spacerun: yes;">&nbsp; </span>They seem to be able channel some deep place that produce performances disconnected from their already superior talent and fitness.<span style="mso-spacerun: yes;">&nbsp; </span>I can’t tell you how many times I’ve drawn upon that to push myself to new personal heights.<span style="mso-spacerun: yes;">&nbsp; </span><o:p></o:p></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="font-family: Times, Times New Roman, serif;">But Scott’s desire to <span style="color: #262626;">"… Burn Out than to Fade Away" seems a bit dismal.<span style="mso-spacerun: yes;">&nbsp; </span>I can’t help but draw parallels to actors (Heath Ledger and Phillip Seymour Hoffman come to mind) we see that party themselves into oblivion and death, leaving everyone around them discussing how tragic that loss of talent is.<span style="mso-spacerun: yes;">&nbsp; </span>Isn’t there some middle ground?<span style="mso-spacerun: yes;">&nbsp; </span>I’ve never met Dr. John Hellemans, but Gordo has shared his philosophy of focused training intermittently to maintain that balance of health and athletic achievement.<span style="mso-spacerun: yes;">&nbsp; </span><o:p></o:p></span></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="color: #262626;"><span style="font-family: Times, Times New Roman, serif;">I don’t want to misinterpret or dramatize Scott’s intention.<span style="mso-spacerun: yes;">&nbsp; </span>But I do hope that I continue to personally define the fine balance between the same enviable traits that produce performance with the restraint necessary to prevent tragic self-destruction.<span style="mso-spacerun: yes;">&nbsp; </span>In my world, this is less about world-class achievement and more about simple diet and fitness choices that prolong optimal health.<o:p></o:p></span></span></div><div class="MsoNormal"><br /></div><!--[if gte mso 9]><xml> <o:DocumentProperties> <o:Revision>0</o:Revision> <o:TotalTime>0</o:TotalTime> <o:Pages>1</o:Pages> <o:Words>310</o:Words> <o:Characters>1772</o:Characters> <o:Company>Shilt Orthopaedics</o:Company> <o:Lines>14</o:Lines> <o:Paragraphs>4</o:Paragraphs> <o:CharactersWithSpaces>2078</o:CharactersWithSpaces> <o:Version>14.0</o:Version> </o:DocumentProperties> <o:OfficeDocumentSettings> <o:AllowPNG/> </o:OfficeDocumentSettings></xml><![endif]--> <!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:TrackMoves/> <w:TrackFormatting/> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:DoNotPromoteQF/> <w:LidThemeOther>EN-US</w:LidThemeOther> <w:LidThemeAsian>JA</w:LidThemeAsian> <w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> <w:DontGrowAutofit/> <w:SplitPgBreakAndParaMark/> <w:EnableOpenTypeKerning/> <w:DontFlipMirrorIndents/> <w:OverrideTableStyleHps/> <w:UseFELayout/> </w:Compatibility> <m:mathPr> <m:mathFont m:val="Cambria Math"/> <m:brkBin m:val="before"/> <m:brkBinSub m:val="&#45;-"/> <m:smallFrac m:val="off"/> <m:dispDef/> <m:lMargin m:val="0"/> <m:rMargin m:val="0"/> <m:defJc m:val="centerGroup"/> <m:wrapIndent m:val="1440"/> <m:intLim m:val="subSup"/> <m:naryLim m:val="undOvr"/> </m:mathPr></w:WordDocument></xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" DefUnhideWhenUsed="true" DefSemiHidden="true" DefQFormat="false" DefPriority="99" LatentStyleCount="276"> <w:LsdException Locked="false" Priority="0" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Normal"/> <w:LsdException Locked="false" Priority="9" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="heading 1"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 2"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 3"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 4"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 5"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 6"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 7"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 8"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 9"/> <w:LsdException Locked="false" Priority="39" Name="toc 1"/> <w:LsdException Locked="false" Priority="39" Name="toc 2"/> <w:LsdException Locked="false" Priority="39" Name="toc 3"/> <w:LsdException Locked="false" Priority="39" Name="toc 4"/> <w:LsdException Locked="false" Priority="39" Name="toc 5"/> <w:LsdException Locked="false" Priority="39" Name="toc 6"/> <w:LsdException Locked="false" Priority="39" Name="toc 7"/> <w:LsdException Locked="false" Priority="39" Name="toc 8"/> <w:LsdException Locked="false" Priority="39" Name="toc 9"/> <w:LsdException Locked="false" Priority="35" QFormat="true" Name="caption"/> <w:LsdException Locked="false" Priority="10" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Title"/> <w:LsdException Locked="false" Priority="1" Name="Default Paragraph Font"/> <w:LsdException Locked="false" Priority="11" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtitle"/> <w:LsdException Locked="false" Priority="22" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Strong"/> <w:LsdException Locked="false" Priority="20" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Emphasis"/> <w:LsdException Locked="false" Priority="59" SemiHidden="false" UnhideWhenUsed="false" Name="Table Grid"/> <w:LsdException Locked="false" UnhideWhenUsed="false" Name="Placeholder Text"/> <w:LsdException Locked="false" Priority="1" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="No Spacing"/> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading"/> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List"/> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid"/> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1"/> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2"/> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1"/> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2"/> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1"/> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2"/> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3"/> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List"/> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading"/> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List"/> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid"/> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 1"/> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 1"/> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 1"/> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 1"/> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 1"/> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 1"/> <w:LsdException Locked="false" UnhideWhenUsed="false" Name="Revision"/> <w:LsdException Locked="false" Priority="34" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="List Paragraph"/> <w:LsdException Locked="false" Priority="29" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Quote"/> <w:LsdException Locked="false" Priority="30" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Quote"/> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 1"/> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 1"/> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 1"/> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 1"/> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 1"/> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 1"/> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 1"/> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 1"/> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 2"/> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 2"/> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 2"/> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 2"/> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 2"/> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 2"/> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 2"/> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 2"/> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 2"/> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 2"/> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 2"/> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 2"/> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 2"/> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 2"/> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 3"/> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 3"/> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 3"/> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 3"/> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 3"/> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 3"/> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 3"/> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 3"/> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 3"/> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 3"/> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 3"/> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 3"/> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 3"/> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 3"/> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 4"/> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 4"/> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 4"/> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 4"/> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 4"/> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 4"/> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 4"/> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 4"/> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 4"/> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 4"/> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 4"/> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 4"/> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 4"/> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 4"/> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 5"/> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 5"/> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 5"/> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 5"/> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 5"/> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 5"/> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 5"/> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 5"/> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 5"/> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 5"/> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 5"/> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 5"/> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 5"/> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 5"/> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 6"/> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 6"/> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 6"/> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 6"/> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 6"/> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 6"/> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 6"/> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 6"/> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 6"/> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 6"/> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 6"/> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 6"/> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 6"/> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 6"/> <w:LsdException Locked="false" Priority="19" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis"/> <w:LsdException Locked="false" Priority="21" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis"/> <w:LsdException Locked="false" Priority="31" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference"/> <w:LsdException Locked="false" Priority="32" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Reference"/> <w:LsdException Locked="false" Priority="33" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Book Title"/> <w:LsdException Locked="false" Priority="37" Name="Bibliography"/> <w:LsdException Locked="false" Priority="39" QFormat="true" Name="TOC Heading"/> </w:LatentStyles></xml><![endif]--> <!--[if gte mso 10]><style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:Cambria; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin;} </style><![endif]--> <!--StartFragment--> <!--EndFragment--><br /><div class="MsoNormal"><span style="color: #262626;"><span style="font-family: Times, Times New Roman, serif;">In any regard, it is nice to quickly jot down some thoughts this morning to pass onto these guys.&nbsp; Hopefully my future choices will buy me a little more quality time. &nbsp;Good luck in finding your balance.&nbsp; </span><span style="font-family: Calibri;"><o:p></o:p></span></span></div><div class="MsoNormal"><span style="color: #262626;"><span style="font-family: Times, Times New Roman, serif;"><br /></span></span></div><div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-mRMRd39AfNE/UxeFRy9ER1I/AAAAAAAAATk/lugXmok8A6Y/s1600/IMG_1003.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/-mRMRd39AfNE/UxeFRy9ER1I/AAAAAAAAATk/lugXmok8A6Y/s1600/IMG_1003.jpg" height="320" width="240" /></a></div><div class="MsoNormal"><span style="color: #262626;"><span style="font-family: Times, Times New Roman, serif;"><br /></span></span></div>Jeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com0tag:blogger.com,1999:blog-328590154258908658.post-14505812959939319932013-10-10T21:06:00.000-06:002013-10-10T21:27:25.763-06:00My Current Basic WeekIt was fun to read <a href="http://http//www.endurancecorner.com/How_to_Qualify/Gordo/Base_Prep">Gordo’s basic week examples </a>this week. He started me on a <a href="http://www.endurancecorner.com/team_interviews/Jeff_Shilt">basic week</a> several years ago, and I’ve used that concept since then to prepare for races and different periods of just keeping fit. The structure, especially when not pressured for a specific event, is a nice way to maintain a decent baseline of fitness.<br /><br />My goal event this year is a trip down to Perth with <a href="http://http//www.katebevilaqua.com">Kate Bevilauqa</a> to race her home race, IM WA and watch her regain the crown she first took in 2010. Of course, I have a little side bet with <a href="http://www.guycrawford.us/index.html">Guy Crawford </a>as well on the spread of our finish times. Should be a great trip and I’m excited to see Kate’s hometown and beautiful Western Australia.<br /><br />I thought some might find it interesting to see a Basic Week in context to real life performances. So here it goes. I have attempted to keep the workouts in context (x * pace) so one could “plug and play” their paces. For example, all the swims are on 1:25-130 yd base time, which corresponds to my IM base time.<br /><br /><u>Mon:&nbsp;</u><br />am 3k swim IM base, 30 min run*<br />pm 90 min bike IM watts<br /><br /><u>Tues:&nbsp;</u><br />am 2.5 hr bike@<br />noon: +/- swim<br />pm 30 min run*<br /><br /><u>Wed:&nbsp;</u><br />am 3k swim IM base, 30 min ez run<br />pm 1 hr bike IM watts<br /><br /><u>Thurs:&nbsp;</u><br />am 1hr run in foothill trails, steady effort<br />pm 1:30 run on the flats* on Boise river greenbelt<br /><br /><u>Fri</u>:<br />am 3k swim IM base, 30 min run*<br />pm 1 hr bike ez<br /><br /><u>Sat:</u><br />am 4.5 k swim IM base, 4-5 hr bike%, 30 min run#&nbsp; <br /><br /><u>Sun:&nbsp;</u><br />Unstructured run/bike with Erin or nothing<br /><br /><span style="background-color: blue;">&nbsp;LEGEND:&nbsp;</span><br />*30 sec/mile faster than my PR IM run split<br /><br />&nbsp;#1 mile ez, 1 mile on track very solid effort sub 6 min pace, ez recovery 15 min<br /><br />@warm up, 4-6 20 min sessions with 4 min hard hill effort followed by 16 min recovery, cool down<br /><br />% 4-5 sets of 45 min IM PR +5 watts power with 15 min ez.<br /><br /><u style="background-color: blue;">IM Discipline PR’s&nbsp;</u><br />Swim: 1:27/100 yds pace Louisville 2011<br />Bike: 2.9 watts/kg Kona 2011<br />Run: 7:42 min/mi Canada 2007<br /><br />&nbsp;Good Luck with your basic week. Dr. JJeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com0tag:blogger.com,1999:blog-328590154258908658.post-2577418776909236192012-08-26T18:17:00.004-06:002012-08-26T18:19:33.422-06:00USA pro cycling challenge Stage 6 Stage 6 Golden to Boulder For a continental team, today is what it is all about. Serge (Serghei Tvetcov) was really coming into form throughout the week. After a tough first day with the Garmin boys smashing it from the gun, he finished with Cadel Evans 12:43 down. Day two’s greetings were much better, and he finished in 39th only 51 secs down on a very difficult finish at Crested Butte. Given the lost time on GC and plans later in the week to spring Freddie for a sprint win on Friday, Tad (director) instructed the team to ride smoothly to the Aspen Finish. The instructions remained the same for Beaver Creek where Jens Voigt benefitted from the peloton apparently having similar plans. We were anxiously awaiting Friday’s finish into Colorado Springs. Unfortunately, the combination of altitude, poor air quality from Colorado fires, and Freddie’s asthma caught up with him. Despite progressively moving into perfect position in the 3 lap criterium-like finale, Freddie’s lungs were not feeding the legs well enough to finish off the sprint. However, the only bright spot was Serge was able to pull him into position before Freddie waved him off, confirming his on coming form. There was some disappointment in the team meeting on Thursday night, but this was quickly dismissed. Attention was directed to the mountaintop Queen stage finish on Flagstaff in Boulder. After huge efforts early in the week to gain KOM points, Boulder resident and GC guy, Cookie (Matt Cooke) was trashed. However, his local knowledge was invaluable in reconnaissance of the course. Serge and Andres were to go on the attack, with Matt, Freddie, and Morgan to finish in the pack. <div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-3inMAU5YUHc/UDq7aPzcs4I/AAAAAAAAASI/nJqjRO9z814/s1600/IMG_0363.JPG" imageanchor="1" style="margin-left:1em; margin-right:1em"><img border="0" height="300" width="400" src="http://1.bp.blogspot.com/-3inMAU5YUHc/UDq7aPzcs4I/AAAAAAAAASI/nJqjRO9z814/s400/IMG_0363.JPG" /></a></div> The Garmin Team discussing strategy during the first climb as attack formed. The attack was formed on the first climb shortly after leaving Golden. Serge successfully made that group and the fight was on. It was an incredible day in the break, gaining upwards of 5 minutes on the peloton as we made our way through Boulder. Serge further confirmed his explosiveness as he picked up top points on the first sprint on the way up to Ned. <div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-cRXn3w4gx5M/UDq701uaaDI/AAAAAAAAASU/erL5PxsBJis/s1600/IMG_0362.JPG" imageanchor="1" style="margin-left:1em; margin-right:1em"><img border="0" height="300" width="400" src="http://2.bp.blogspot.com/-cRXn3w4gx5M/UDq701uaaDI/AAAAAAAAASU/erL5PxsBJis/s400/IMG_0362.JPG" /></a></div> Mo carefully reviewing who is in the break to help determine if it would stick The plan was to conserve his energy for the remainder of the stage, as an attack was unlikely to hold on the mostly downhill section from Ward and through Lyons. As the group was motivated to continue to work together till the final climb, we knew there would be one further selection at Lee Hill. Serge lost contact right before the KOM, but revealed his true mettle as he was able to fight back on during the descent. It was incredible racing through the massive crowds lining the road. I can only imagine what it must have been like for the guys on their bikes, as just being in the car was crazy enough. The break had whittled down to only 8 guys and Serge was representing Team Exergy incredibly well. They hit Flagstaff with a 2 minute lead on the yellow jersey. Rory Sutherland, Fabio Aru, and Jens Voigt were able to hold off the rest of the peloton to finish 1-2-3. Serge remained tough and finished as the 6th guy of the break. However, the GC guys were well rested in the peloton and were able to really unload the last 5k of Flagstaff, relegating him to 27th of the day right behind Tom Danielson. Though unlikely that a casual fan would appreciate the result, this was a great fight by Serge and he represented Team Exergy well in the break all day. <div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-0bN83qNzxw0/UDq8fovrd_I/AAAAAAAAASg/qBLJD8n04sA/s1600/IMG_0334.JPG" imageanchor="1" style="margin-left:1em; margin-right:1em"><img border="0" height="300" width="400" src="http://2.bp.blogspot.com/-0bN83qNzxw0/UDq8fovrd_I/AAAAAAAAASg/qBLJD8n04sA/s400/IMG_0334.JPG" /></a></div> The crazy crowds Jeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com0tag:blogger.com,1999:blog-328590154258908658.post-82705740218401713062012-08-20T21:58:00.000-06:002012-08-20T21:59:15.658-06:00USA Pro Challenge Day 1Durango to Telluride 126 miles in 4:42, averaging nearly 27 mph despite 8800 ft of climbing. Impressive, what a way to start the tour! From the beginning... The guys get their bikes in the morning after Josh has dialed the machines in over the preceding 2 hours . Nearly everyone has some bit of a routine...hurried, laid back, diligent. Many of the the guys will write down notes regarding the course. Here is Sergei's...came in handy as he was in the main break of the day with all of the big hitters. <div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-rYmpIn4T7-s/UDMAJFndu8I/AAAAAAAAAQ4/8nQlOD5d2Wk/s1600/IMG_0259.jpg" imageanchor="1" style="margin-left:1em; margin-right:1em"><img border="0" height="400" width="300" src="http://3.bp.blogspot.com/-rYmpIn4T7-s/UDMAJFndu8I/AAAAAAAAAQ4/8nQlOD5d2Wk/s400/IMG_0259.jpg" /></a></div> Matt Cooke (ex triathlete, current GC/climber guy) is one of the diligent ones. He carefully checks his bike to make sure the brakes aren't rubbing, the skewers and headset are tight, computers are working, the hoods haven't moved, not too much throw in the brakes...a very thorough run through to confirm his bike is as he wants it. <div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-TJo0Jpbrl1E/UDMBYekIwwI/AAAAAAAAARE/JWZ_BI1NzLI/s1600/IMG_0258.JPG" imageanchor="1" style="margin-left:1em; margin-right:1em"><img border="0" height="300" width="400" src="http://3.bp.blogspot.com/-TJo0Jpbrl1E/UDMBYekIwwI/AAAAAAAAARE/JWZ_BI1NzLI/s400/IMG_0258.JPG" /></a></div> The guys head to the start to sign in. As they do that, all the different vehicles head out to take care of their respective jobs for the day. Scott (Escalera Mgmt) and Troy (soigné) are off 2 hrs before the start to haul the van to the finish and get ready to receive the riders. Tad (Director) & Gary (Asst. Director) fill their cars with Josh, Mo, and guests. Mike (soigné), Remi (Escalera Mgmt and cool dude), and myself have feed zone duties. Each team has lunches provided by race organization. Here is Mike picking up ours. <div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-Blg8o86Kxbk/UDMCyDmGDwI/AAAAAAAAARQ/FxGU1We_wFU/s1600/IMG_0260.jpg" imageanchor="1" style="margin-left:1em; margin-right:1em"><img border="0" height="400" width="300" src="http://4.bp.blogspot.com/-Blg8o86Kxbk/UDMCyDmGDwI/AAAAAAAAARQ/FxGU1We_wFU/s400/IMG_0260.jpg" /></a></div> The feed zone folks head out first in front of the start so we can get ahead of the peloton and set up. Generally we will try to pick up a spot on an slight uphill so the pace isn't crazy fast when they go by. There is a certain technique to handing off the musettes which I learned from the Liquigas soigné at the Tour of California this past year. Never run with the riders is key and foremost. Don't get to far into the road, stand still, bag high, release. You definitely don't want to be the guy causing a crash...and believe me, I've seen it! It gets ugly when somebody causes a crash in the feed zone and riders go down. Today was awesome as Sergei and Matt were both in the break with the big hitters. Matt picked up some KOM points and Sergei took max points at one of the intermediate sprints. <div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-Bcss7kzwaeM/UDMEU6mmIJI/AAAAAAAAARc/Ys8WSc273LQ/s1600/IMG_0261.jpg" imageanchor="1" style="margin-left:1em; margin-right:1em"><img border="0" height="400" width="300" src="http://3.bp.blogspot.com/-Bcss7kzwaeM/UDMEU6mmIJI/AAAAAAAAARc/Ys8WSc273LQ/s400/IMG_0261.jpg" /></a></div> What was most impressive about today was the pace. These guys were killing it from the gun and really putting the pressure on from the first kilometer. It was sort of funny, as apparently Tom Danielson was telling Freddie that he thought the day was going to be easy and everyone was going to cruise it. Shortly thereafter, Garmin attacks with 4 guys up the road, including Danielson. Nothing like a little friendly gamemanship. We had a lot of great riding today. Freddie managed to make the 1st chase group that caught the final break and was able to take 4th at the line. This was after apparently suffering an asthma attack in the first part of the stage and almost pulling out. Amazing how fine a line sports performance can be. Andres also had a great first day and finished at the same time as winner Tyler Farrar. Here is a shot from behind the finish line as we were waiting for the sprint. <div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-f3Yu2EMtbMA/UDMGgoM-CGI/AAAAAAAAARo/a_-KjQwiw1I/s1600/IMG_0264.JPG" imageanchor="1" style="margin-left:1em; margin-right:1em"><img border="0" height="300" width="400" src="http://2.bp.blogspot.com/-f3Yu2EMtbMA/UDMGgoM-CGI/AAAAAAAAARo/a_-KjQwiw1I/s400/IMG_0264.JPG" /></a></div> At the finish, the concentration immediately goes to recovery. Short spin to hotel, Recovery Pump System boots, recovery drinks, massage, dinner, race briefing, more Recovery Pump boot time and off to bed. <div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-CvZfLMc4E9U/UDMHCNnT_II/AAAAAAAAAR0/OLkXXO6sfYg/s1600/IMG_0268.jpg" imageanchor="1" style="margin-left:1em; margin-right:1em"><img border="0" height="400" width="300" src="http://1.bp.blogspot.com/-CvZfLMc4E9U/UDMHCNnT_II/AAAAAAAAAR0/OLkXXO6sfYg/s400/IMG_0268.jpg" /></a></div> Should be another tough but exciting day tomorrow. J Jeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com0tag:blogger.com,1999:blog-328590154258908658.post-352173405096185512012-08-19T22:10:00.000-06:002012-08-19T22:10:46.912-06:00USA Pro Cycling Challenge-Pre Race T minus 1 with Team Exergy So the fitness has been gathered over the prior months and the team patiently awaits the last big race of the year in Colorado. It has been solid year for the team, but you can see the toll it has taken on the riders and staff. There is certainly a different sense from everyone in comparison to the first big stage race of year at the Tour of California. So, other than pitching in a hand for any odd job that needs to be done, my primary role is to help everyone recover as well as one can from day to day. Though I certainly can’t help anyone gain fitness, I can make sure I provide the best tools available for the guys to get ready for the next day. This includes Recovery Pump System to flush the legs pre- and post- rides, cooling system for the hot days, optimal nutrition that is easy on the stomach yet provides adequate calories and nutrients, and addressing musculoskeletal ailments from saddle sores to road rash. These are items available to every team, but you would be surprised how easy it is to neglect recovery when the cyclists and staff are fatigued. The Recovery Pump System has been a great addition this year. We are able to get the guys in the “legs” for as much time as they want each evening. It really makes the soigneur’s job that much easier; the general comment is how much more supple the guys muscles are in comparison to when we didn’t have them available. I haven’t seen anyone run into a problem being in them too much…and trust me, some of the guys stay in them for a good deal of time. I have found the graduated, optimal compression pressure and quick cycling of the pressure to be key components that separate these compression boots to others on the market. And it is key that they are easily transportable…we don’t have a problem throwing them in our bags for flights or the day transfers during the tour. <div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-DXv8xluX-qM/UDG3QTgEpmI/AAAAAAAAAQU/FVCPVKYkSjM/s1600/IMG_0252.jpg" imageanchor="1" style="margin-left:1em; margin-right:1em"><img border="0" height="400" width="300" src="http://1.bp.blogspot.com/-DXv8xluX-qM/UDG3QTgEpmI/AAAAAAAAAQU/FVCPVKYkSjM/s400/IMG_0252.jpg" /></a></div> So, what does the night before the first stage look like? After dinner, we had the pre-race briefing for the riders discussing everyone’s role for tomorrows stage, pointing out areas that are strategic to accomplish the different race goals. The riders pitch in where prior experience or local race knowledge is helpful. It is always interesting to see how the day rolls out in comparison the race plan. Some days its like clockwork…some days, not so much. <div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-tPwpoGXFTG0/UDG4YeJB-wI/AAAAAAAAAQk/520ZAK6wDTw/s1600/IMG_0253.JPG" imageanchor="1" style="margin-left:1em; margin-right:1em"><img border="0" height="300" width="400" src="http://2.bp.blogspot.com/-tPwpoGXFTG0/UDG4YeJB-wI/AAAAAAAAAQk/520ZAK6wDTw/s400/IMG_0253.JPG" /></a></div> Following the racers briefing, the staff meet and we discuss everyone’s role for the day. Most of the roles are relatively established, but nuances nearly always exist. The mechanic(s) are up at the break of dawn getting the bikes ready. The soigneurs are preparing the bags and nutrition for the day, the rest of the staff are splitting feed zone and driving duties. Somebody has to leave early with the trailer prior the race departure to set up the next hotel. Feed zone staff go ahead to the feeding area and then back ahead of the race to help set up recovery at the finish. The director and asst. director are in 2 different cars behind the peloton. If we are in the break, our lead car heads goes ahead of the peloton with the break while the 2nd car assist the guys in the peloton. Most days, guests and media folks are riding in the cars as well. So tomorrow it all begins… breakfast will begin at 5 am, bags at the trailer by 8:15, early car departure by 9, and the race begins at 10 am. So see you on the road. Ride the Wind with Team Exergy Jeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com0tag:blogger.com,1999:blog-328590154258908658.post-57360299641198982102011-05-06T19:52:00.007-06:002011-11-06T18:28:36.183-07:00IM St. George 2011 and Midfoot Cleat Position<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://2.bp.blogspot.com/-k96ooK7fPAc/TcSt3xr0BbI/AAAAAAAAANU/6SY2CWZHa28/s1600/IMG_0207.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 238px; height: 320px;" src="http://2.bp.blogspot.com/-k96ooK7fPAc/TcSt3xr0BbI/AAAAAAAAANU/6SY2CWZHa28/s320/IMG_0207.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5603795010097251762" /></a><br />Bike Position 2011<br /><br />Note the mid foot cleat position. I switched to this position approximately 4 months prior to the race because of metatarsalgia I would experience during long rides the past few years. The forefoot pain was bad enough that it hampered my running. Other conditions I think this would be helpful in include: Morton's Neuroma, chronic calf cramping, Achilles Tendinitis, Plantar Fasciitis, any forefoot issues.<br /><br />The change in cleat position completely eliminated my pain. I did make the necessary changes in bike position as recommended by <a href="http://www.trainingbible.com/joesblog/2007/01/cleat-position.html">Joe Friel</a>, <a href="http://www.stevehoggbikefitting.com/blog/2011/04/power-to-the-pedal-cleat-position/">Steve Hogg</a>, and others. I didn't do the modifications myself a la Joe, but had Don Lamson with <a href="http://www.d2shoe.com/home/cleatplacement.html">D2 shoes</a> custom fabricate a pair. These are great shoes, but I will make further modifications on future pairs. My original set up caused the mid portion of my shoe to rub excessively against the cranks. I eventually changed to speedplay pedals with longer spindles to accomodate. This has worked fine. Additionally, I would like mine to be slightly more forward than prescribed. Preferably 10 mm, though this <a href="http://forum.cyclingnews.com/showthread.php?t=8790">link</a> suggests 5mm worked for him.<br /><br />One must have a real awareness of the bike handling issue that can occur. Turning sharply with either foot in a forward position will clip your front wheel. Unfortunately I learned this the hard way...a few times. I don't recommend this position if you are racing criteriums or technical mountain biking until you have gained substantial experience. My understanding is that Goetz Heine, originator of the position & Biomac shoes, has made custom bikes to help ease this issue.<br /><br />Additionally, the mid foot position really fatigues my gluteals and upper quads tremendously in comparison to my more standard forefoot position. This has improved, but I would certainly plan on at least 3 months of habituation before any A race.<br /><br />Shoot me any questions you might have.<br /><br />JJeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com4tag:blogger.com,1999:blog-328590154258908658.post-4302612825582092452010-11-09T20:58:00.004-07:002010-11-09T21:15:59.183-07:00Man Camp 2011<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://2.bp.blogspot.com/_NK8STT8OIhQ/TNobemXPEFI/AAAAAAAAANE/zThmUbsfDac/s1600/IMG_0035.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 239px;" src="http://2.bp.blogspot.com/_NK8STT8OIhQ/TNobemXPEFI/AAAAAAAAANE/zThmUbsfDac/s320/IMG_0035.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5537768904313475154" /></a><br />So details for next years camp are forming. We are doing the Quizno's Challenge Colorado Bike Race course the week preceeding the scheduled race, with a <span style="font-style:italic;">little</span> swim & run added in.<br /><br />We devised our plan for subsequent years camps...each original "MAN" can invite 1 additional guest next year. He is responsible for the guest in all ways...if doesn't hack it, neither are invited the next year. After the camp, the original cast extends invites back. Next years attendees will include Camp Founders Justin Daerr & Gordo Byrn, original campers Mark Pietrofossa, Scott Carr, myself, with unanimous invites Marilyn & Chris McDonald. Actually Chris wasn't unanimous, but his wife was. We felt pity for Big Sexy and invited him anyway. We decided with her many years of racing on the NRC circuit and chasing Big Sexy around, she probably grew a set of tackle to be included. <br /><br />The invites should are forthcoming...this is certainly not for the faint of heart. I've had a few enquiries already during last years camp and subsequently...be careful what you ask for!!!! More details to come.<br /><br />J<br /><br />P.S. The pic above is enjoying a cool one after the final days ride...Idaho Springs up Mt. Evans and and then on to Boulder. There was a sprint for the final city limit sign into Boulder...suffice to say Gordo has given me plenty of motivation for next years camp. You will have to ask him for the story...Jeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com0tag:blogger.com,1999:blog-328590154258908658.post-15175156384242712892010-08-11T20:20:00.002-06:002010-08-11T20:44:51.092-06:00Man Camp Day #3<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://1.bp.blogspot.com/_NK8STT8OIhQ/TGNgFu8JVrI/AAAAAAAAAM0/kwu2Cvt_JcU/s1600/x2_2488a7f.jpeg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 239px; height: 320px;" src="http://1.bp.blogspot.com/_NK8STT8OIhQ/TGNgFu8JVrI/AAAAAAAAAM0/kwu2Cvt_JcU/s320/x2_2488a7f.jpeg" border="0" alt=""id="BLOGGER_PHOTO_ID_5504348821192791730" /></a><br />2 Pass Day<br /><br />After our swim session and massive breakfast, a mandatory nap was called before the morning rollout. I have to say that was a nice way to start and given the delay (and a little Linkin Park) I rolled the 1st 8 miles to the beginning of the switchbacks on Berthoud Pass at a good clip. I did feel a little better today than the past few and took advantage of the perky feeling. <br /><br />Having done a few camps in the past, I'm well aware of what training load I can typically back up. Just to hang on the past few days on a couple of Gordo's pulls and to complete the climbs was all the intensity I needed. And generally speaking, I enjoy leaving the camps in better shape than I come. For me, this means a lot of humility and taking it easy through the 1st part of the week.<br /><br />In any case, 13 miles, 2,500- 3000 feet of climbing, and 60 minutes later I hit the top of the pass. I was able to crest before the rest of the MEN except Gordo (who dropped me like rock when we hit the steep stuff) on the account of my sneak attack right out of the gate. <br /><br />After regrouping, we cruised together until the base of Loveland Pass. Needless to say my earlier effort doomed any attempt at a fast ascent up this one. We got a group pic at the top and cruised into Dillon. I gave it a shot at the city limit sign sprint, but even dead assed tired Petro can easily ride me of his wheel, though the attack was quite far out and equally as sneaky as mine at the rollout.<br /><br />We finished up the day with our standard 5 mile run before dinner. Gordo & Petro were feeling a little peppy and negative split the way home. Unfortunately this generated some later dinner discussion and JD has now introduced sprint primes into our runs. Look out folks, I think this may cause some damage.<br /><br />JJeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com0tag:blogger.com,1999:blog-328590154258908658.post-55819702981019470872010-08-10T18:48:00.003-06:002010-08-10T19:09:25.516-06:00ManCamp Day #2<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://4.bp.blogspot.com/_NK8STT8OIhQ/TGH3z1qFKXI/AAAAAAAAAMs/AtacGVe64vM/s1600/IMG_0007.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 239px;" src="http://4.bp.blogspot.com/_NK8STT8OIhQ/TGH3z1qFKXI/AAAAAAAAAMs/AtacGVe64vM/s320/IMG_0007.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5503952689572424050" /></a><br />A tough day today...there is nothing tranquil about 130k of riding with 7500 ft. of elevation gain, 5 miles running, and pool session. <br /><br />My plan was to remain as steady as possible, but all those went awry after beginning the climb out of Estes Park into Rocky Mountain National Park. It was a beautiful ride, peaking out above 12,000 feet, but there is no way to take that easy. We regrouped right before the top; JD & Gordo rolled over the top together and a fortunate road construction stop allowed Scott & I to go over the top just behind Petro.<br /><br />An awesome descent into Grand Lake and a good stop for a bona fide breakfast. Of course, Gordo drilled it out of town and pulled a very solid pace. The heart rate frenzy to stay on created a bit of issue with the digestion...needless to say the massive shunting of blood to my gut kept the legs pretty anemic. I was definitely "shunted" and as we hit the climb into Frazier I was happy to voluntarily pull the plug and cruise back into town with Scott. This was my only shot at normal gut peristalsis resuming this evening.<br /><br />We headed out for 5 mile run; nothing is easy at 8,500 feet. The swim was certainly no better. Fortunately with self-appointed medical waiver for my shoulder (Camp Doc has its privileges!), I took it a bit easier than the rest of the boys.<br /><br />Heading to dinner...we are all salivating at the dinner aroma Jen has all cooked up. More tomorrow.<br />JJeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com0tag:blogger.com,1999:blog-328590154258908658.post-53131979354017532282010-08-09T13:58:00.004-06:002010-11-09T20:53:16.645-07:00ManCamp 2010I will be blogging this week from Colorado as we do some training there @ the 1st Annual Mancamp. For info on the genesis of the camp, check out Gordo's <a href="http://www.endurancecorner.com/Gordo_Byrn/ManCamp">Blog</a>. The basic gist goes like this...<br /><br />"the idea for ManCamp came when Justin (Daerr) and I were drilling it up a mountain. I can’t remember where but the climb was long, and hard, so I’m guessing it was Arizona or Colorado. We were smacking it and J leaned over and said, “this is man training.” Something about his tone made me laugh and the concept of man training was born. I suppose there’s a little boy living in me and he likes to be a man every once in while."<br /><br />Having trained with the boys in the past, this will be a solid week of swim/bike/run with a heavy emphasis on the bike. <br /><br />I'm recovering from a nasty GI bug last week that threatened my presence at the camp, so the first few days will be as tranquil as the terrain will allow. Today we started off with a little "renegade" training, as my kind 1st night Boulder homestay (thanks Brooke) JD revolted from the 5:45 swim. We got a nice 5 miles on the Wonderland Trail before meeting up with the boys for our ride (JD says renegades of Funk by Rage Against The Machine should be in the background of all of our renegade sessions from hereafter).<br /><br />Mayor meeker, Taylor & Chris from SC joined in for the ride up to Estes Park. It was a nice steady pull up Big Thompson Canyon until Glen Haven, then I took the caboose over peak into Estes. Solid 3hours and change of riding to ease into camp. More to come.Jeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com0tag:blogger.com,1999:blog-328590154258908658.post-14252661826949765652010-06-26T13:21:00.002-06:002013-10-10T21:09:35.892-06:00Eccentric exercises for RunnersI've written extensively in the past regarding the benefits of eccentric exercises for rehabilitation of a variety of overuse injuries.<br /><br />But I also feel strongly that eccentric leg exercises are very valuable in strength training for runners who may have biomechanical limitations in regard to training volume. I will commonly reduce training volumes in athletes with these concerns and replace some training with eccentric exercises to increase the durability in the muscles crucial for running. Note that most of these exercises were developed to fix chronic tendinopathy. In this use, returning the limb to neutral by the uninjured limbs is important. This isn't the case in using the eccentric training for increasing run durability.<br /><br />My routine includes strengthening the following muscles:<br />1. Hip Abductors (gluteals)<br /><br />The pelvic drop exercise is completed by standing on a step with the exercised leg, while holding onto a wall or stick if necessary for support. With both knees locked, the opposite, noninvolved pelvis was lowered towards the floor. Then, the suspended leg is lowered even further by bending the supporting leg. Finally, the suspended leg swivels and goes through the swing phase of gait by first swinging forward then backwards while the exercised leg stabilized the body by contracting the gluteus medius on that side.<br /><br />The reference used below describes a different exercise but supports eccentric strengthening for ITB syndrome.<br /><br /><br />2. Knee Extensors (Quadriceps)<br /><br />Place your feet shoulder-width apart on an <br />decline board. Lower yourself while standing on the knee intended for exercise (bend the knee approximately <br />60 degrees), then raise yourself while standing on the opposite knee. Build up to three sets of <br />ﬁfteen repetitions, twice a day. You can add dumbells to increase weight as you progress.<br /><br />3. Calf Muscles (Gastrocsoleus)<br /><br />Stand with all your body weight on the exercised leg. From an upright position and standing with all body weight on the forefoot, with the heel extended off the back of a step, the calf muscle is loaded by having lowering the heel beneath the step. The foot is then brought back to neutral with either the use of both ankles. In rehabbing injured ankles, non-injured leg is used to return to the starting position. <br /><br />********<br />The eccentric strengthening of the muscles allow them to be more resistant to the destruction we see during race efforts and hard running.<br /><br />I hope you find these helpful.<br /><br />Dr. J<br /><br />References:<br />1. P Jonsson, H Alfredson. Superior results with eccentric compared to concentric quadriceps training in patients with jumper’s knee: a prospective randomised study. Br J Sports Med 2005;39:847 850 LINK: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1725058/pdf/v039p00847.pdf<br /> <br />2. M A Young, J L Cook, C R Purdam, Z S Kiss and H Alfredson Eccentric decline squat protocol offers superior results at 12 months compared with traditional eccentric protocol for patellar tendinopathy in volleyball players 2005;39;102-105 Br. J. Sports Med. <br /><br />3. Alfredson, H., Pietila, T., Jonsson, P. & Lorentzon, R. Heavy-load eccentric calf muscle training for the treatment of chronic Achilles tendinosis. Am J Sports Med 1998 May-Jun;26(3):360-6<br /><br />4. Alfredson, H. & Lorentzon, R. Chronic Achilles tendinosis: recommendations for treatment and prevention. Sports Med. 2000 Feb;29(2):135-46.<br /><br />5. Fredericson M, Wolf C. Iliotibial band syndrome in runners: innovations in treatment. Sports Med. 2005;35:451–459. 21. Fredericson M, YamamotJeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com1tag:blogger.com,1999:blog-328590154258908658.post-43426308413404202512010-03-19T07:15:00.003-06:002010-03-21T14:47:19.132-06:00EC Tucson Camp Wrap Up & Anti-cycling sentiment<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://2.bp.blogspot.com/_NK8STT8OIhQ/S6aF0FTRzcI/AAAAAAAAAMk/wEqcYc54glg/s1600-h/IMG_0021.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="http://2.bp.blogspot.com/_NK8STT8OIhQ/S6aF0FTRzcI/AAAAAAAAAMk/wEqcYc54glg/s320/IMG_0021.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5451191528801291714" /></a><br />Just got back this past weekend from our Spring Endurance Corner Tucson Camp. The camp was incredibly well organized by camp director and pro triathlete Justin Daerr. It was great to see old & new campers alike and, like always, gain some early season inspiration from my training partners. <br /><br />The pic above is the pool we swim...great environment to kick off the training season.<br /><br />I also to forward this email I received from my buddies in TriCoWS (Tri Club of Winston-Salem. This is one task worth doing. See below<br /><br />Recently Tony Kornheiser of ESPN went on a rant against cyclists going as far as advocating running over them. Some of his comments included:<br /><br />"Run them down, like Wile Coyotes, run them over. Just stay on the right. Stay on the right."<br /><br />"And they all wear...my God...with the little water bottle in the back and their stupid hats and their shiny shorts, they are the same disgusting poseurs that come out in the middle of a snow storm with cross country skiing on your block. Run them down."<br /><br /><br />I have just filed a complaint with the FCC. I would ask all of you to do the same. Given the recent death of Adam Little, we don't need people like this on the public airwaves. <br /><br />To file a complaint go to: http://esupport.fcc.gov/complaints.htm<br /><br />Click on the radio button: Broadcast (TV and Radio), Cable, and Satellite Issues.<br /><br />Proceed to the next page. Click on the radio button: Unauthorized, unfair, biased, illegal broadcasts (does NOT include Obscene, Profane or Indecent material) This does however, include "Broadcasting threatening or intimidating statements about an individual or group."<br /><br />Proceed to the next page and select the online form. Complete your consumer information. You will then need to complete Form 2000E. Pertinent information that needs to be included:<br /><br />1. What is the name of the company that is the subject of your complaint? Red Zebra Broadcasting (ESPN 980)<br /><br />2. If your complaint is about a radio or television station, provide the following information: Station call sign (e.g., "KDID," "WZUF," "KDIU-FM," "WZUE-TV"): WTEM, WWXX and WWXT<br /><br />Station location: City: Rockville State: Maryland<br /><br />If you are complaining about a particular program, provide the following information: <br />1. Network: ESPN980 <br />2. Program name: Tony Kornheiser Show <br />3. Date of program (mm/dd/yyyy): 3/11/2010 <br />4. 10:00 am<br />5. Provide the details of your complaint, including the time, date and nature of any conduct or activity complained of and identifying information for companies, institutions or individuals involved (if not already described above): During his show on March 11, 2010, Mr. Kornheiser advocated violence against anyone riding a bicycle on a public road. Specifically, Mr. Kornheiser stated "Run them down, like Wile Coyote's, run them over." Using public airwaves to advocate violence against cyclists is unacceptable and should not be tolerated. <br /><br />Please take a moment to file the complaint and forward this on to others. Hopefully, we can get morons like Tony Kornheiser off the airwaves, and maybe, just maybe, make cycling a little bit safer. <br /><br />Thanks,<br /><br />TricowsJeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com4tag:blogger.com,1999:blog-328590154258908658.post-58813874705834983002009-11-08T10:13:00.002-07:002009-11-08T10:24:35.523-07:00Silverman 2010 & Camp Solitude<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://2.bp.blogspot.com/_NK8STT8OIhQ/Svb-eJPJfWI/AAAAAAAAAMI/IBbSt4sCRGI/s1600-h/IMG_0099.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="http://2.bp.blogspot.com/_NK8STT8OIhQ/Svb-eJPJfWI/AAAAAAAAAMI/IBbSt4sCRGI/s320/IMG_0099.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5401784596906474850" /></a><br />Last year I did the swim & bike at Silverman in an effort to recon the course for racing this year. As life would have it, didn't have my life in balance to put the training effort together to race the course like I wanted. So, my brother aka, Johnny Salsa, crazy johnny, quadjranch is racing the half ironman. <br /><br />His buddy, Greg Petty, is tweeting live from the racecourse today. You can follow on quadjranch on twitter.<br /><br />Hope everyone is enjoying the fall. I'm up in McCall today with my lovely wife working on Camp Solitude.<br /><br />JJeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com0tag:blogger.com,1999:blog-328590154258908658.post-84661067156498434812009-09-11T12:38:00.003-06:002009-09-11T12:52:55.680-06:00Final Gear Selection<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://1.bp.blogspot.com/_NK8STT8OIhQ/SqqZa54V4II/AAAAAAAAALY/kyih0sxXfDw/s1600-h/100_2049.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 240px; height: 320px;" src="http://1.bp.blogspot.com/_NK8STT8OIhQ/SqqZa54V4II/AAAAAAAAALY/kyih0sxXfDw/s320/100_2049.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5380281392340263042" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://4.bp.blogspot.com/_NK8STT8OIhQ/SqqZaOjjRCI/AAAAAAAAALQ/MGMKevqz1Og/s1600-h/100_2092.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="http://4.bp.blogspot.com/_NK8STT8OIhQ/SqqZaOjjRCI/AAAAAAAAALQ/MGMKevqz1Og/s320/100_2092.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5380281380710335522" /></a><br />There was a few changes prior to race day. The lower picture is the final race day gear in comparison to what I planned to use in the top picture. I will comment on a few things and leave some others for a different post.<br /><br />My "secret weapon" was the pull buoy carved out to stuff our required gear and fashioned around our waist with a old tube. It worked brilliantly. I was able to store all of my necessary gear in the buoy-the cell phone or GPS unit, whistle and compass fit there without difficulty. I had tied the pull buoy tight enough that it didn't bounce when running at all and with one easy pull would fall into place between my legs for the swim. When I would stand up from the swim, it would pop back into place on its own. Seamless transitions in that regard.<br /><br /> There were a changes with a few items that we were on the fence about. The webbed gloves vs paddles debate literally continued up to race morning. However, the edge was given to the paddles b/c they were faster in my pool TT's and weren't as fatiguing. The fingertip paddles were the ideal size in that they were definitely faster, but not excessively tiresome. I ended the day without any huge issues from them at all. However, they weren't easy to transition and they were a real handicap getting in and out of the water. On the steep climbs immediately out of deep water required a lot of additional strength that I didn't really have. The gloves would have been nice to get that extra grab. My ideal solution would be to have thin neoprene gloves with finger paddles. I would add a carabiner to my tube to allow me to carry them on the long runs.<br /><br />There are many things I would do different. Poor equipment choice alone cost us 30 minutes...very frustrating. More to come in my race report. <br /><br />Now recovering and back to work,<br />JJeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com2tag:blogger.com,1999:blog-328590154258908658.post-71099007803674127622009-09-07T19:18:00.003-06:002009-09-07T19:20:09.328-06:00Post Race O till O<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://3.bp.blogspot.com/_NK8STT8OIhQ/SqWxCMgLL_I/AAAAAAAAALI/mDmed2Z3Ua8/s1600-h/100_2083.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 240px; height: 320px;" src="http://3.bp.blogspot.com/_NK8STT8OIhQ/SqWxCMgLL_I/AAAAAAAAALI/mDmed2Z3Ua8/s320/100_2083.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5378899981237956594" /></a><br /><br /><br />8th Overall, 10:38<br /><br />race report to follow.Jeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com1tag:blogger.com,1999:blog-328590154258908658.post-49240321136460889572009-09-05T12:27:00.004-06:002009-09-05T19:53:28.987-06:00O till O Gear Selection<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://1.bp.blogspot.com/_NK8STT8OIhQ/SqKugztdNkI/AAAAAAAAALA/neoyKkcRhdc/s1600-h/OtillO+Gear.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 258px; height: 320px;" src="http://1.bp.blogspot.com/_NK8STT8OIhQ/SqKugztdNkI/AAAAAAAAALA/neoyKkcRhdc/s320/OtillO+Gear.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5378052783693706818" /></a><br />Last fall my brother called me after Jonas Colting had won and wrote his race report on a unique race called O till O. It was intriguing and Erin suggested that we go do the race to celebrate my brother’s 30th Birthday. <br /><br />So, here we are. We’ve spent the past few months accruing run miles and swim yardage. My largest week included 70 miles of running and 25k of swimming, so nothing astronomical. Despite 5 months of base training, I biomechanically challenged myself that week. Fortunately all is well and we have no injuries to speak of.<br /><br />One interesting aspect of the race is the lack of formal transition areas. Despite going from swim to run ( and one bike section) 40 times, you keep all of your gear with you every step of the way. People have tried many different solutions for gear, including kick boards, flippers, water-tight bags for shoes, etc. We’ve taken Jonas’ advice and decided to run in our wetsuit and swim with our tennis shoes and avoid any gear changes. This put heightened awareness upon our gear selection. We’ve spent a few sessions testing different combinations. What you see above is my final section, minus my “secret weapon”….I will disclose that after the race, depending on how well it works. A couple of choices you might find interesting…the <a href="http://www.blueseventy.com/products/list/category/wetsuits/">Blue Seventy</a> webbed gloves will serve dual function in warmth and providing a paddle effect. One of the test sessions I soaked 4 pairs of different shoes and then weighed them…the <a href="http://www.zootsports.com/">Zoots</a> won, saving 2 pounds of dead weight. My shoulder hasn’t quite recovered enough to overcome the resistance of a sleeved wetsuit, so I’m going sleeveless. <a href="http://www.infinitnutrition.us/"> Infinit</a> remains my nutrition of choice…no worries about the right mix of calories, electrolytes and sugary taste. The pic above contains nearly my entire race kit.<br /><br />Hope the rest of you are enjoying your summer adventures. You can see mine live tomorrow by watching real time GPS <a href="http://www.multisportlive.com/CompetitionSL.aspx?courseid=102">updates</a> online.<br /><br />JJeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com1tag:blogger.com,1999:blog-328590154258908658.post-49883437260913529372009-08-14T09:08:00.006-06:002009-08-15T12:08:09.463-06:00Poker Pacing IIPoker Pacing 100's<br /><br />A few years ago, I wrote the basic <a href="http://www.gordoworld.com/alternativeperspectives/2007/08/poker-pacing.html">approac</a>h I use to prepare for Ironman run training. I've been toying with a few different sessions that incorporate another key element of efficient running, high cadence, into these workouts.<br /><br />Increasing cadence has significant benefits in reducing the biomechanical load of running. In turn, the increased cadence reduces the risk of overuse injuries. An improvement in this technical aspect alone can reap huge benefits for most runners in regard to recovery and preserving lower extremity health. In addition, it is much easer to increase foot speed and maintain that foot speed for greater duration during training runs and races. Increasing cadence any amount can be beneficial; the goal cadence is 92-94 strides per minute. You can calculate this by counting how many times one foot strikes the ground in 15 seconds and multiply by 4. <br /><br />After one gets relatively skilled at poker pacing (negatively splitting) workouts, then the next element is to raise cadence. For this 10k workout, I recommend raising your cadence 6-8 foot strikes/minute. The first mile is done at a pace very slow, concentrating on raising the cadence substantially above your comfort zone. This requires moderate concentration...most people feel awkward in running with such a high cadence and slow pace. The goal is to maintain that cadence as you increase the pace 20-30 sec/mile, ending with a pace 30 sec greater thany your open 10k pace.<br /><br />For example, my last 10k race was a trail run a few weeks back that I finished in 38:55, or around 6:15. So, my workout looked like this:<br /><br />9:15 120<br />8:45 124<br />8:15 128<br />7:45 134<br />7:15 138<br />6:45 144<br /><br />The goal is raising cadence while maintaining pace. If need be, slow down the pace to accomplish your goals.<br /><br />Have fun and enjoy the workout.<br /><br />JJeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com2tag:blogger.com,1999:blog-328590154258908658.post-35256036635217391152009-07-26T12:35:00.006-06:002009-08-27T10:16:01.163-06:006 Week Countdown to Ö till ÖMy big event this year is <a href="http://www.otillo.se/index_english.php">Ö till Ö</a>, a one day event that takes place on an archipelago off the coast of Stockholm, Sweden. I will be teaming up with my brother, commemorating his 30th birthday. <br /><br />The challenge should be a good one, as our individual triathlon weaknesses are opposite, but yet both comprise the race. John, in relative terms, has been the slower runner. He has put in a really great running base this year since moving to Boise. We just completed a 3 week block with 54/57/60 miles running. We've included a variety of terrain, including some tough uphill sections in the Boise Foothills. This past week he surged towards the end of one of our 16 mile runs...I was certain he was going to blow up. Instead, he finished strong and was able to carry that effort to the finish. <br /><br />Swimming has certainly been my "achilles tendon" in the past. After a bigger effort this past year, my swim times significantly improved. I was able to put down one of my faster swims with a good buddy of mine in SoCal, <a href="http://www.coachkp.com/">KP</a>, this spring at the end of a 4k swim recording a low 14:xx effort. However, a re-injury of a chronic shoulder issue flared-up and I had a <a href="http://en.wikipedia.org/wiki/SLAP_tear">SLAP tea</a>r surgically repaired on 3/2/9. Since that time, it has been full-on with recovery and rehab. I was cleared to swim without restrictions at 4 months post-op, but had started kicking and drills a month before that. Though I have a ways to go to get back to sub 14:30, I've made significant gains in my 1000 TT efforts every week.<br /><br />One of the fun component of the race is the multiple transitions and choosing appropriate gear. We've spent some time trialing some different gear options in some swim-run bricks, but we haven't chosen our final gear. More of that time to come in the upcoming weeks.<br /><br />One other aspect of the race that is neat is the <a href="http://www.be-safe.se/otillo2008/">live tracking</a> of the event. During the race, each team keeps a GPS which can be followed on line to track progress. Pretty cool.<br /><br />Hope your summer training is going well.<br />Dr. JJeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com0tag:blogger.com,1999:blog-328590154258908658.post-1200485861346671592009-07-19T21:57:00.005-06:002013-10-10T21:10:32.741-06:00Stress Fractures<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://3.bp.blogspot.com/_NK8STT8OIhQ/SmPvn08yL7I/AAAAAAAAAK4/FHGKDSHN2ls/s1600-h/image002.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 239px; height: 320px;" src="http://3.bp.blogspot.com/_NK8STT8OIhQ/SmPvn08yL7I/AAAAAAAAAK4/FHGKDSHN2ls/s320/image002.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5360391449008549810" /></a><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://4.bp.blogspot.com/_NK8STT8OIhQ/SmPrvG-SSJI/AAAAAAAAAKg/q8Umoe1Wpu4/s1600-h/Inf.+Pubic+Rami+Stress+Fx.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 256px;" src="http://4.bp.blogspot.com/_NK8STT8OIhQ/SmPrvG-SSJI/AAAAAAAAAKg/q8Umoe1Wpu4/s320/Inf.+Pubic+Rami+Stress+Fx.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5360387176059259026" /></a><br /><br />I've been fortunate enough to spend time with a great triathlete and good friend, Kate Bevilaqua the past few months. Fortunate for those of us in Boise, she chose to spend the Northern Hemisphere summer training here. The past several months have been filled with some unfortunate injuries, the most recent a inferior pubic rami stress fracture. With her permission, I've loaded her most recent x-ray on the bottom (right side, bottom of the "O ring" in the pelvis). Recently, I was forwarded another pro triathletes x-ray with a femoral neck stress fracture (upper xray...note the lucency in the superior part of the bone between the ball and the hip). I thought it might be worthwhile discussing the basics of stress fractures. In upcoming posts I will delve a bit further into more detail in the training aspects when returning from healing fractures. The bulk of this article was recently posted on Endurance Corner's Feature article at www.xtri.com.<br /><br />Stress fractures are the result of repetitive biomechanical stress to bones which do not recover from that stress. Anyone may develop a stress fracture so long as the involved level of activity produces stress greater than the bone’s ability to resist it. The fracture occurs when repetitive activities produce nonpainful microfractures of bone trabeculi. If the collective stresses remains below a specific threshold (different for each individual) or if the athlete rests between episodes of stress, the microfractures will heal. On the other hand, if the athlete continues the offending activity the microfractures will increase to the point that pain will occur with activity. This is the first symptom of a stress fracture in most individuals, although some athletes may limp without complaining of pain. If the athlete heeds the pain and reduces the stress at this point, the fracture should heal without other treatment. If the athlete continues with the activity, the stress fracture will become more evident clinically and radiographically.<br /><br />There are conditions that mimic stress fractures. Some conditions are the result of overuse, such as tendinitis or periostitis (inflammation of the periosteum surrounding the bone) and cause similar symptoms. In fact, these condition are likely an earlier finding along the continuum of overuse injury that leads to a stress fracture. Stress reactions, the term used to distinguish the earliest such findings, are accelerated remodeling with bone marrow or soft tissue inflammatory changes.<br /><br />Rarely bone lesions can cause similar pain. The most common of these rare lesions is benign condition called an osteoid osteoma. The pain of an osteoid osteoma usually does not increase with activity, however. It will cause pain at times of both activity and inactivity, especially at night. Both lesions will produce periosteal reactive bone and cortical thickening. Even more rarely, certain malignant lesions can cause bone pain. Also rare, an area of subacute or chronic bone infection may simulate a stress fracture.<br /><br />The diagnosis of a stress fracture can generally be made by the history of progressive pain following increasing training loads, accompanied by point tenderness of the affected bone at the point of the stress fracture. Stress fractures may present for diagnosis and treatment before the plain x-rays are abnormal, because radiographic changes frequently lag behind clinical symptoms by weeks. In individuals with symptoms of a stress fracture with normal radiographs, a bone scan or MRI will confirm the diagnosis. The longer the patient is symptomatic, the more evident the fracture becomes.<br /><br />Some people more prone to the development of a stress fracture than others. Since stress fractures are the result of excessive stress, and abnormally angulated bones or extremities result in increased stresses delivered to bone, abnormal limb alignment increases the chance of development of a stress fracture. For example, an athlete with a varus deformity of the hindfoot (opposite of a flat foot) will place more stress than normal on the base of the fifth metatarsal, which may result in the development of a stress fracture of the proximal diaphysis of the fifth metatarsal (Jones fracture). Limb length discrepancies are likely risk factors as well. Hormonal abnormalities, specifically in females, increase the risk of stress fractures as well. Though beyond the scope of this article, new information suggests that ammenorrhea, when coupled with chronic energy deficit as the result of inadequate caloric intake and increased exercise, result in an increased combined risk of fracture.<br /><br />Stress fractures in running athletes occur most commonly in the bones of the lower leg and foot. Their most common location is in the posterior medial aspect of the proximal tibia, but the 2nd metatarsal is also frequently seen. However, fractures of the spine, pelvis, hip, femur, tibia and foot have been reported. Though not well-documented, the location of stress fractures in triathletes is similar to runners, albeit, it seems to occur with a lower incidence. <br /><br />The treatment of stress fractures is based upon by classifying them as either high-risk or low-risk for complicated outcomes. High-risk stress fractures occur in the superolateral femoral neck, anterior tibial shaft, tarsal navicular, proximal fifth metatarsal, and talar neck. These require immediate attention and often surgery. <br /><br />Examples of low-risk stress fractures occur in the lateral malleolus, calcaneus, 2nd through 4th metatarsals, and the femoral shaft. The reason to differentiate the two is that the undertreatment of high-risk stress fractures can lead to completion of the fractures with disastrous outcomes. On the other hand, overtreatment of low-risk stress fractures can result in unnecessary deconditioning, prolonged immobilization, and subsequent increased fracture risk. <br /><br />Daily supplementation with 2,000 Mg of calcium and 800 IU of vitamin D has been shown to decrease the risk of new stress fractures. This should certainly be entertained by those new to the sport or anticipating an increase in training load. If ammenorrheic, your physician will likely recommend an oral contraceptive to normalize hormone levels.<br /><br />The return to regular training is highly individualized to both athlete and fracture location, but commonly takes 8-12 weeks at minimum. This return to activity should be closely monitored by a physician familiar with endurance sports medicine.<br /><br />Best of luck with your summer training,<br />Dr. JJeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com0tag:blogger.com,1999:blog-328590154258908658.post-73184684768873347302009-03-14T16:13:00.003-06:002009-03-14T16:39:03.663-06:00Stretches for Running<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://4.bp.blogspot.com/_NK8STT8OIhQ/SbwwMKxpzPI/AAAAAAAAAKY/hqFjVYsqc-8/s1600-h/LA%14pet_sifferbo_trippeln.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 318px;" src="http://4.bp.blogspot.com/_NK8STT8OIhQ/SbwwMKxpzPI/AAAAAAAAAKY/hqFjVYsqc-8/s320/LA%14pet_sifferbo_trippeln.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5313174645999521010" /></a><br /><br />Many of you might recognize the guy above...it is a good buddy, Clas Bjorling. A few years back at an Epic Camp we attended, he shared with me his thoughts on stretching for performance and the prevention of injury. If a guy running 2:42 off the bike and sub 2:30 in an open marathon talks about running improvement, I tend to find utility. Here are my thoughts a few years later after treating myself and others.<br />***<br /><br />I see (and experience) my share of overuse running injuries. The initial injury can be debilitating, but often the subsequent aches and pains are a result of a cascade effect from the initial injury/overuse/weakness. The offending injury then results in overload of other muscles, and their subsequent tightness.<br /><br />Often times, treatment is directed at the source of pain. Many times we ignore the initial symptoms and initiate compensatory mechanisms that overload other muscles in an effort to protect the initially weak muscle.<br /><br />Start with this simple routine...I find it useful for nearly all running related injuries. The emphasis of the flexibility program is directed towards the running core stabilizing muscles that can be tight. Relieving the tightness throughout the all of the running muscles is more effective than isolating the affected muscle alone.<br /><br />These stretches are commonly found in most Yoga classes. And though typical Yoga classes are great, most of us are too fatigued to participate on a regular basis in the midst of heavy triathlon training. For this reason, I've collected a set of passive stretches that are very restful that you can complete without a lot of additional active work They really work best when you are really fatigued:<br /><br />childs pose<br /><br />down dog or bent knee calf stretches, leaning forward on hands <br /><br />hero or lion pose<br /><br />fire log pose<br /><br />half lord of the fishes or sage<br /><br />reclining big toe pose (use strap)<br /><br />...sorry for the yoga terms; go to yogajournal.com for pics of poses. <br /><br />Hope this is helpful. <br /><br />Dr. JJeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com0tag:blogger.com,1999:blog-328590154258908658.post-32225389302309941532009-01-21T07:02:00.004-07:002009-01-21T08:49:46.072-07:00Bike Fit, Part II<img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="http://2.bp.blogspot.com/_NK8STT8OIhQ/SXcsBsVChSI/AAAAAAAAAJY/ZYw0EaFK1NY/s320/Jeff_Bike_Fit_006.jpg" border="0" alt="" id="BLOGGER_PHOTO_ID_5293748294588204322" /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://3.bp.blogspot.com/_NK8STT8OIhQ/SXcsB6lCKvI/AAAAAAAAAJg/3tvc5aV0HDE/s1600-h/Jeff_Bike_Fit_008.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="http://3.bp.blogspot.com/_NK8STT8OIhQ/SXcsB6lCKvI/AAAAAAAAAJg/3tvc5aV0HDE/s320/Jeff_Bike_Fit_008.jpg" border="0" alt="" id="BLOGGER_PHOTO_ID_5293748298413386482" /></a><br />I changed out the photo from the bike fit, part 1 blog. I originally couldn't find my 2003 IM Brazil bike pic, which was my first ironman. I finally found it and posted. Take a look and compare to above. Kind of fun.<div><br /></div><div>***</div><br />On to the next step in the evolution of my bike fit. During my time in Boulder, I scheduled a bike fit with the guru at the Boulder Center for Sports Medicine, Andy Pruitt. He, along with Todd Carpenter ran me through their program. <br /><br />After filling out a basic intake questionnaire, we discussed if I was interested in a performance or problem oriented fit. A performance fit would concentrate on improving power output through position changes. A rough estimate of the aerodynamic profile could be performed as well. The most aerodynamic position in which maximal power output can be obtained is eventually sought. Although comfort is not the primary outcome in this sort of fit, the position must be sustainable for the given distance. If the position is not sustainable, then a less aerodynamic position is used until it can be maintained for the race condition. This position should be measured in a real life situation and compared to the prior position. <br /><br />In a problem oriented fit, a thorough biomechanical assessment is performed to determine underlying pathology. A physical exam was performed by a frontal and back coronal view to determine obvious pelvic obliquity and truncal imbalance. Flexibility was examined to determine any areas that might prevent a position otherwise prescribed a particular formula (more to come on next post). This included an exam of my neck, back, and lower extremities (hip flexor/hamstrings/ankles). A thorough physical exam, including a strength evaluation, was completed.<br /><br />I chose the performance fit, as I had been able to ride my current position in a few ironmen with reasonable success (5:09 IM Brazil bike split).<br /><br />We then headed in to the bike fit studio where my bike was already set up on the trainer by Todd Carpenter. Todd had studied at the Univ. of Colorado and had done some interesting work on aero position vs uncompromised comfort position on the effect of TT performance. In a nutshell, comfort wins.<br /><br />I completed a baseline power exam on my the position I presented with (top picture). Then we applied the motion monitor markers (little glow balls on my body) and recorded kinematic data. Using this data, we made some adjustments in fit to gain the correct angles and range of motion during the spinning cycle. Adjustments were also made to my cleats to address knee tilt and avoid loss of power generation by movements that were not driving the leg directly into the pedal (tibia straight up and down like a piston as opposed to elliptical motion). <br /><br />Though I was interested in improving performance, the changes we made were to improve comfort (bottom pic). I raised my handlebars in order to allow the upper back to reduce the amount of cervical lordosis required to look up the road. This, and the cleat positioning, composed the majority of change. We tested the second position with a similar power test, which resulted in a lower heart rate average for the same power output.<br /><br />All in all, this was a great experience. It confirmed the fit I had tinkered on since my fit with David Greenfield was pretty good. The additions of cleat adjustment was great fine tuning. The biggest take home was that comfort, even for performance, nearly always trumps "intuitive" aero changes. My one disappointment was the inability to test different positions that might have increased power output, in addition to making the one position I had more economical. I may be splitting hairs and there may not be any difference. As you will see in part 3, I think you can take the comfort caveat and still have room for additional power improvements.Jeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com1tag:blogger.com,1999:blog-328590154258908658.post-57420295666316034802009-01-13T17:21:00.005-07:002009-01-21T08:32:55.578-07:00Evolution of my Bike Fit-Part 1<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://4.bp.blogspot.com/_NK8STT8OIhQ/SXdAHUrNp0I/AAAAAAAAAJo/drDNwcwuG_I/s1600-h/Ironman+Brazil-Cycle.bmp"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="http://4.bp.blogspot.com/_NK8STT8OIhQ/SXdAHUrNp0I/AAAAAAAAAJo/drDNwcwuG_I/s320/Ironman+Brazil-Cycle.bmp" border="0" alt="" id="BLOGGER_PHOTO_ID_5293770381550528322" /></a><br />I thought it would be interesting to talk about the evolution of my bike fit as I start tinkering with my fit, as I usually do early in the season. It is a lengthy conversation and I will break it into 2 parts. The second will include some of my current thoughts on bike fit. Enjoy!<br />***<br /><br />My first bike purchase was one that I bought one night while on call during my fellowship. I was waiting for a patient to be brought to the OR from the ER and was leafing through a cycling catalogue and came upon closeout deal on a Fuji Aloha. I was prompted to close the deal quickly as some of the Vanderbilt residents were going to do a triathlon and I wanted to do it as well. I’d never owned a bike and certainly knew nothing about an appropriate bike fit.<br /><br />Typical for most closeout deals, there were only a few sizes left. The online operator convinced me that I would be fine with one of the remaining frame sizes, so I went with it. Nine frames, 3 cycling shop fits, one custom 3D fit and 9 ironman later, my expectations from a bike has evolved and is quite different than where I started. My bike needs started with concerns about comfort, skipped to looking good, moved on to desire to go fast and has now returned full circle to comfort.<br /><br />How I would define comfort has changed as well. My early rides were simply limited by perineal (crotch) comfort. I suspect my early discomfort was simply a process of learning to ride and finding a position that accommodated the particulars of my build and flexibility. These early fits however, were the result of my own fiddling and left a tremendous room for improvement. I went from a bike too large to one that was too small, before abandoning TT bikes for a road bike.<br /><br />With help from Ken’s Bike Shop, I was finally able to ride comfortably. I was able to finally spend more time on my bike by 2002 and I actually logged some consistent miles for the first time riding consistently 3 times/week. When it became spring time and triathlon season, I slapped a pair of aerobars on the bike and rode on. This set up served me reasonably well and I finished my first IM in Brazil in the following year.<br /><br />By this time, I began getting more serious about triathlon and wanted to look like on of the guys on the cool TT bikes. After a bit of research I decided to go visit David Greenfield at Elite Bicyles in Philadelphia. After receiving the best customer service during a bike fit I’ve ever experienced (and a day in the life with Richie and the gang is a story I will never forget), I decided to purchase a Razor. His attention to detail during my fit to accommodate my flexibility (or lack thereof), yet reach a reasonably aero position was greatly appreciated. Through a combination of increased training volume, improved comfort and aerodynamics, and inspiration from my cool new bike I was able to return to IM Brazil 2 years later in 2005 and improve my bike time nearly 20 minutes, gaining my first Kona slot along the way.Jeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com1tag:blogger.com,1999:blog-328590154258908658.post-19444603254238162902009-01-04T20:47:00.009-07:002009-01-07T04:56:21.122-07:00Winter Big Day Training<div><br /></div><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://2.bp.blogspot.com/_NK8STT8OIhQ/SWGDCy9DlAI/AAAAAAAAAJI/e58aGqOu-yk/s1600-h/IMG_0923.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 240px; height: 320px;" src="http://2.bp.blogspot.com/_NK8STT8OIhQ/SWGDCy9DlAI/AAAAAAAAAJI/e58aGqOu-yk/s320/IMG_0923.JPG" border="0" alt="" id="BLOGGER_PHOTO_ID_5287651521570509826" /></a>I have to admit that the past few years I've been envious of the Northern athletes that spent the off-season cross training by doing winter sports. After our move to Boise, the Shilt household has been anxiously awaiting the first big snowfall to hit <a href="http://www.bogusbasin.org/nordic/index.aspx">Bogus Basin</a>. Fortunately, we haven't been disappointed. I was able to have my first <span class="Apple-style-span" style="font-style: italic;"><span class="Apple-style-span" style="font-weight: bold;">Winter</span></span> Big Day Training that included an hour swim, hour run, then 2 hours of skate skiing...well sort of. Fortunately Erin was kind enough to circle back and give me a few tips &amp; there were a few brief moments of Eureka! Needless to say, I don't think anyone attending <a href="http://www.liberec2009.com/">Liberec</a> in a month has anything to worry about.<div>****</div><div>A couple of things you might be interested in.</div><div><br /></div><div>The first is that Gordo has re-invented his website. The new site, <a href="http://www.endurancecorner.com/">Endurance Corner</a>, is comprised of two components. The basic platform, free to all, is comprised of all the articles and blogposts that he has authored over the past 10 years. Also included are Alan Couzens's insightful blogs and the podcasts that Gordo and Justin Daerr have put together. </div><div><br /></div><div>There is a subscription component as well. This will include unlimited access to Gordo and the rest of the Endurance Corner team on his forum and a customized coaching plan. </div><div>****</div><div>The final note is about the last few remaining spots at our spring training camp in Tucson. The training was outstanding last year and you can expect the same this year. Unique this year will be daily lectures and case reports on Medicine and Endurance Sports. For those in the health care field, you may be able to deduct a portion of the camp as a business expense. (Of course, you should consult with your tax professional for your particular situation before making any tax or legal decisions!!!). For those in the coaching business, there will be USAT coaching credits available as well.</div><div><br /></div><div>****</div><div>I hope all is well and everyone is enjoying the new year as much as we are. </div><div><br /></div><div>J </div>Jeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com2tag:blogger.com,1999:blog-328590154258908658.post-43257524912128085962008-11-10T16:37:00.003-07:002008-11-10T16:58:43.274-07:00Silverman Report<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://2.bp.blogspot.com/_NK8STT8OIhQ/SRjGRJajXII/AAAAAAAAAIc/iqn_jrHZODc/s1600-h/IMG_0047.JPG"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 320px; height: 240px;" src="http://2.bp.blogspot.com/_NK8STT8OIhQ/SRjGRJajXII/AAAAAAAAAIc/iqn_jrHZODc/s320/IMG_0047.JPG" alt="" id="BLOGGER_PHOTO_ID_5267177762097159298" border="0" /></a><br />Whew!!! The Silverman is definitely a challenge and certainly earns it billing of "the toughest course in North America". Without further delay, here are the details of my training day:<br /><br />Total calories out (calculated): 5812<br /><br />Swim 1:20 max 152 avg 138<br /><br />Bike 6:02 max 162 avg 145<br /><br />Swim:<br /><br />The swim conditions vary widely. I swam at Boulder Beach (unprotected part of the course near the turnaround) the day before the race without a wetsuit. The water temperature was perfect and I was surprised at the reported reading. The water is very clear with 20 ft visibility and smooth as glass. Race day was quite different and lived up to all of the hype.<br /><br />The course is L shaped (Imagine the “L” standing on its short leg with the long leg pointing to the left). The initial out section is with the current and reasonably fast. Every turn buoy is yellow, which helps with navigation. The long out and back section can be more challenging to navigate. Not only does it whitecap here, but the narrow distance between the out and back buoys makes them very easy to confuse when sighting. The long return section was definitely more difficult b/c of the current and conditions, but nothing like the short return leg. I’m not certain if it was mostly conditions, but there was a much larger current and bigger swells. My time on this short section was equal to one of the longer legs. The swim was very humbling and reminiscent of my first Ironman swim.<br /><br />Note: I certainly didn’t need a full wetsuit. This is the first time I’ve worn one since 2003. It was very confining and far too hot. When I got out of the water, I wasn’t surprised to see my swim time... See comment above re: IM Brazil 1:36 swim in 2003.<br /><br />Bike:<br />The initial hill climb out of T1 is challenging. It is very difficult to keep the hr rate low, even with a restrained effort. Once on main road, there is 11 miles of rollers leading up to the right hand turn. Not a lot of opportunity to get settled. There is a tail and crosswind. I rode with a front 808 and a disc. Unless you are very comfortable with crosswinds, this can be daunting choice. This dilemma begs the question of deciding between what your capable and what is prudent-I technically had no issues with the wheel choice, but spent a considerable time riding leaning over. Despite a conscious effort to relax my upper body, it got a good workout. If I would have run, my trunk was fatigued, and that would have made a tough run more difficult. I’ve not ridden a tri spoke, but the combined climbing and little aero loss should at least make this a consideration.<br /><br />The out and back section is a continuous section of climbing and descending. There are no steep climbs; instead, just moderately long stretches of false flats to climb and descend. The road surface is pristine until about mile 40. At this juncture, it is turns to chip seal and is very bumpy with many places that are too uneven to sit through. The 10 miles to the turnaround and back is where I first fell considerably off pace despite a constant effort.<br /><br />Milepost 85, or the last five miles back to the original turn off, was the second considerably slow section. There is a long gradual climb and headwind. Unfortunately it never gets easier during the remaining portion of the bike ride. After a short section back on the highway, you reach a section literally on a bike trail. The bike trail beginning marks the location of the “3 sisters”, a series of short climbs reportedly reaching the 18% grade. Short of one sustained downhill for a few miles, the last 22 miles are relentless. You are constantly turning and climbing and going through repeated stop signs, traffic lights, and neighborhoods.<br /><br />I’m glad I did this reconnaissance. I’m sure my less than optimal condition affected my perception, but I really have a lot of respect for the guys that completed the day. This is hands down the most difficult course I’ve encountered.<br /><br />In one of my upcoming posts, I will address my thoughts on how to improve the medical care you receive. The challenges I faced the last several months with jaw pain were difficult; I have the deck stacked in my favor with excellent health insurance and job as a physician…I empathize with those who don’t have those luxuries.<br /><br />Hopefully onto a more restful winter,<br /><br />JJeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com4tag:blogger.com,1999:blog-328590154258908658.post-64449418156638355852008-11-08T22:49:00.001-07:002008-11-08T22:50:43.408-07:00An Insider’s PerspectiveI thought I’d share how lucky I am this week...for that matter, how lucky any of us are, that are participating in endurance sports for fun. Two separate stories bring that closer to home this week.<br /><br />The first is about a parent of 3 adopted children that I’ve cared for. Laura finished her first triathlon this year. She got the bug to run a local NC running race and followed that up with her first triathlon. The race director forwarded me a link to a <a href="http://www.youtube.com/watch?v=OAaJWsSlaaU">video</a> she made following the race. This video reminds me why I started doing triathlons: to get in to shape and have fun with my brother. It is also a humble reminder that at the end of my work day, I’m lucky to go home and put in a few hours of training. Laura’s kids require care and attention around the clock; a true 24 hour/day job. And she always does it with a smile. Triathlon truly is a privilege.<br /><br />The second is more personal. After 4 ½ months of jaw pain necessitating multiple dental/endodontist/PCP/neurologist/ENT/oral surgeon appt’s, 5 sets of normal panaromic dental xrays, head &amp; neck CT scan and MRI, months of multiple medications too many to list, repeated blood work, a scheduled biopsy of my mandible next week, all culminated with a trip to the ER on Thurs night/Fri am. After a couple of rounds of dilaudid not relieving the pain, a nerve block finally did the trick. Despite no classical signs of “irreversible pulpitis” (the reason we have root canals) I had one Friday morning as a last ditch effort. Pain gone…enough so, that we decided to go ahead with our plans to check out Silverman this weekend. Ever the optimist, I had sent my back down last week to be built up by the LBS. I still plan to recon the course; we will see how that goes given I’m having a bit of issue as we speak as a result of a weeks worth of Clindamycin wreaking havoc on my normal intestinal flora. Regardless, the absence of the discomfort that I’ve been experiencing since this past June is priceless. It is amazing how much we take for granted and how quickly it can all go away. What am I’m even more amazed is that I’m a physician…I can’t even imagine what a poor soul who had a less insight than I has to go through with a less than clear medical problem. <br /><br />It seems a trivial to report the last time point on the MBT, but ever the academician…this was the only session this week; it is crazy what we do when we have a sense of obligation.<br /><br />Here you go:<br /><br />MBT Results:<br />Date Watts Duration Avg. HR<br />9/28 180 60 min 147<br />10/6 180 60 min 135<br />10/13 180 60 min 131<br />10/20 180 60 min 130<br />10/27 180 60 min 140<br />11/3 180 60 min 137<br /><br />Enjoy the day,<br />JJeff Shilt, M.D.http://www.blogger.com/profile/15846737589529566048noreply@blogger.com3